A Top Down look at Blockchain - the Federal Perspective

HIMSS 19 Blockchain Symposium

Steve Posnack, Executive Director, Office of Technology, ONC

ONC “In a Nutshell”

• ONC focuses on the Administration’s

priority of building a health system that

delivers value and maximizes the

promise of health IT.

• We use our levers to accelerate

individuals’ ability to access and send

their health information so they can

shop for and coordinate care.

ONC’S Mission

Improve the health and well-being of

individuals and communities through

the use of technology and health

information that is accessible when

and where it matters most.

Session objectives

• Outline the work of HHS and the role they play in technology decisions

• Demonstrate how HHS looks at new technologies, and how technologies like

blockchain become part of the discussion

• Discuss HHS’s current blockchain strategy and the expected near and medium

term impacts of those efforts

• Review key considerations for the private sector as they design impactful

solutions

ONC -- A Focus on 21

Century Cures

» Interoperability Efforts:

– Promote standardized, application programming interfaces (APIs)

– Combat information blocking

– Accelerate data exchange between disparate health information

networks.

– Promote patient access to health information

– Administer the Health IT Advisory Committee (HITAC)

» Provider Burden Efforts:

– Develop strategy with the Centers for Medicare and Medicaid

Services (CMS) to reduce administrative and reporting burden

among clinicians.

ONC is focused on the 21

Century Cures Act’s priorities of increasing nationwide interoperability and

reducing clinician burden.

What kind of blockchain do you want to be?

• Public

• Private

• Permissioned

• Permission-less

How “off the chain” are we?

• HHS

» Last year HHS launched Accelerate, which uses distributed-ledger technology, machine learning and artificial

intelligence to deliver real-time information on pricing and terms and conditions from across HHS. It is

designed to facilitate the Federal Acquisition Lifecycle.

• GSA

» https://www.gsa.gov/technology/government-it-initiatives/emerging-citizen-technology/blockchain

• NIST IR8202

» https://www.nist.gov/publications/blockchain-technology-overview

• Congress

» https://www.congressionalblockchaincaucus.com/

• Other work/interest across many other Departments

Overview of ONC engagement

• Blockchain Challenge (Summer 2016)

• Use of Blockchain in Healthcare and Research Workshop (September 2016)

• The Blockchain in Healthcare Code-A-Thon (March 2017)

• Blockchain Technology and Healthcare Webinar (February 2018)

• “Oh the Places Data Goes: Health Data Provenance” Challenge (March 2018)

"Use of Blockchain in Health IT and Health-Related Research" Ideation Challenge

• 15 Whitepaper winners

• https://oncprojectracking.healthit.gov/wiki/display/TechLabI/Blockchain+Challenge+on+ONC

+Tech+Lab

• Smaller sample invited to speak at NIST-ONC workshop

• Winning papers themes included:

» Algorithms, Privacy, and Data

» Claims processing

» Medication reconciliation

» Improving electronic health information exchange and patient engagement

» Secure records storage

» Health research and consent management

» Medicaid applicants

Blockchain in Healthcare Code-A-Thon

• Co-hosted by ONC and the Chamber of Digital Commerce

• March 14 -15, 2017 at Georgetown

University

• Solicited distributed ledger projects that

addressed one or more of the following:

» Identity Management and APIs

» Metadata Tagging and Policy Expression

» Data Aggregation and Linkage

Interoperability in Action Webinar Series #4

Blockchain in Healthcare

• Keynote speaker Justin Herman of General Services Administration (GSA)

• Blockchain NISTer update presented by the National Institute of Standards and

Technology (NIST).

• Presentations from the four 1

round winners of ONC’s Health Data Provenance

Challenge in which participants proposed solutions to real-world obstacles for provenance

in clinical care. Of the four 1

round winners, three proposed solutions based on the use

of blockchain technology.

• HHS Roundtable and Q & A session.

• https://oncprojectracking.healthit.gov/wiki/display/TechLabI/2018+Interoperability+in+Ac

tion+Webinar+Series+%234

Potential Healthcare Blockchain Use Cases – 2+ years later

• Identity Management (Identity, authentication, authorization,) and credential verification

• Access Control and Consent

• Auditing

• New and Improve Workflows

» IRB Clinical Trial approval

» Patient sharing of data

» Supply Chain -- Drug dispensing, monitoring

» Tracking and access to Internet of Things

» Hospital Stays

» Medicaid Eligibility

» Claims process and payment automation

• Off chain record location and viewing

Federal Government Use Cases

• Blockchain use cases other agencies are exploring touch many parts and processes of an organization,

including:

» Financial management

» Procurement

» IT asset and supply chain management

» Smart contracts

» Patents, Trademarks Copyrights, Royalties

» Government-issued credentials like visas, passports, SSN and birth certificates

» Federal personnel workforce data

» Appropriated funds

» Federal assistance and foreign aid delivery

@ONC_HealthIT @HHSONC

THANKS!